The aorta is the main artery which transmits blood from the heart to the entire body. An aortic dissection is a very serious condition in which bleeding occurs within the walls of the aorta. An aortic dissection can occur when bleeding occurs between the layers of the artery walls. Bleeding creates pressure between the layers and the tissues can crack open (dissect). This condition can happen when blood pressure within the aorta is high. When the aortic wall begins to dissect, the vessel can continue to dissect. The cracking process usually continues towards descending aorta and down the vessels that branch off the aorta.
Aortic dissection occurs in 2 out of every 10,000 individuals. Aortic dissection is most commonly seen in men between the ages of 40 and 70. The male-to-female ratio for aortic dissection is about 3:1.
What causes aortic dissection?
Atherosclerosis, high blood pressure and traumatic injury are the main causes for aortic dissection.
An aortic dissection can occur in the part of the artery that is located in the chest, but it can also occur in the part of the aorta that is located in the abdominal area of the body. Trauma to the aorta from a blow to the chest or abdomen could be significant enough to cause an aortic dissection.
Ballooning of the aorta (aortic aneurysm) can also cause an aortic dissection.
Other possible causes for aortic dissection are Marfan syndrome, mitral valve problems, and some connective tissue disorders. People who have had heart surgery may also be at risk for aortic dissection. A rare disorder called Pseudoxanthoma elasticum (a disorder of elastic fibers of the skin, eyes and blood vessels) can also create aortic dissection.
What are the symptoms of aortic dissection?
The symptoms of aortic dissection occur suddenly with severe chest pain and shortness of breath. Chest pain, from an aortic dissection, may be experienced substernal (under the breast bone). The pain may radiate to the shoulder blades, and to the back, and to other parts of the body, such as the jaw, neck, shoulder, arm, abdomen, or hips. In the most severe cases of aortic dissection, the individual may experience pain in the arms and legs also.
An aortic dissection is an emergent situation; the individual will likely have symptoms that mimic a heart attack. The person may experience nausea and vomiting, severe anxiety, pale skin, sweating, and difficulty breathing. The person’s thinking and reasoning abilities may also be impaired. The individual will likely be in a state of panic
How is aortic dissection diagnosed?
The doctor will listen to the heart, abdomen and lungs with a stethoscope. In case of aortic dissection, a “blowing” murmur can be heard with a stethoscope. The doctor will likely order an aortic angiography, a CT scan of the chest, and an MRI of the chest. A chest X-ray and an echocardiogram may also be ordered. Another helpful test may be a Trans Esophageal Echocardiogram (a different type of echocardiogram where the transducer is swallowed) may also be ordered.
What are some treatment options for aortic dissection?
The main objective of treatment is to avoid complications. Aortic dissections can be either Type A (the ascending part of the aorta located in the chest) and Type B (the descending part of the aorta located in the abdomen). Type A aortic dissection must be treated with surgery, while type B aortic dissection may be treated medically.
Drugs which bring down the blood pressure can be prescribed. Generally high pain relievers are needed. Also heart medications like beta-blockers can help in reducing some complaints. Surgery can cure the disease in some cases when the damaged section of aorta can be replaced. Damaged aortic valve is required for valve replacement. In case of heart arteries’ involvement, a coronary bypass is needed.
The goal to prevent this disorder should center on keeping the blood pressure within normal limits, and keeping the blood vessels healthy by preventing atherosclerosis. Medications, such as ACE inhibitors, angiotensin receptor blockers and beta-blockers can decrease the possibility of dissection.
You may be able to prevent aortic dissection by living a healthy lifestyle, which means eating right and getting proper exercise. Your doctor can advise you on what types of exercise will best benefit you to prevent this condition from happening to you.